Many believe that our current medical liability system is broken, citing issues such as rising medical malpractice premiums, untimely and inequitable compensation for truly injured patients, and the questionable impact that litigation has on health care quality, cost, and access to care. These concerns have led to the emergence of medical malpractice as a hotly debated issue on the national health policy stage. Research has been conducted on many different aspects of medical malpractice. This research, however, is uneven, and has often resulted in mixed findings. In general, the majority of empirical research has either been conducted in the aggregate or has focused on a small number of medical specialties which are viewed as having the highest level of risk for malpractice suits such as surgery, obstetrics and gynecology, radiology and emergency medicine. Therefore, we do not really have a clear understanding of how our current medical liability system is impacting primary care specialties such as internal medicine, family practice, or pediatrics. Instead of understanding the etiology and epidemiology of their own claims data, these "ignored" specialties have been forced to rely on anecdotal information or to make inferences from empirical studies of other specialties. As primary care specialties account for the majority of patient visits each year, we believe that it is important to look at historic trends regarding medical malpractice as well as the current state of affairs within this group of providers. Our research proposal will focus specifically on the "ignored" specialties of internal medicine, family practice and pediatrics, in order to better understand the impact that the current malpractice environment is having on these specialties. More specifically, the primary aim of this research proposal is to understand better the occurrence, frequency, types and results of malpractice claims involving the general internists, family physicians, and pediatricians. In order to accomplish this, we will look at the occurrence, frequency, types and results of malpractice claims for the ignored specialties by querying data reported to the Physician Insurers Association of America's (PIAA) data-sharing project. Comparison data will also be pulled for the other specialties recorded in the database. Additionally, there are two secondary aims of this research proposal. By utilizing the epidemiologic data gathered and analyzed for the purposes of our primary aim, we hope to prepare for further work and funding by: 1) identifying key areas where we could develop clinical scenarios and survey questions pertaining to the practice of defensive medicine by physicians in the "ignored" specialties;and 2) identifying areas where liability risk can be reduced and patient safety can be improved for these specialties.